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State of the States August 11, 2023

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Injured federal workers voice concerns with workers’ compensation delays and denials.

NationalAn article released last weekend from NBC highlights the turbulent process for federal workers to file for workers’ compensation. Federal employees and their advocates, including the American Federation of Government Employees (AFGE), say that the Office of Workers’ Compensation Programs (OWCP) processes are “so convoluted that getting approval for medical scans or procedures can take weeks, months or even years.” Numerous injured federal workers are significantly concerned that due to delays in care, their now treatable injuries could run the risk of progressing into lifelong disabilities. The situation is so dire that multiple union representatives at different federal agencies are advising members to file claims under personal health insurance first and then report the workers’ compensation claim after receiving the necessary help. Due to the complications of OWCP’s system, some union representatives are pushing certain members to avoid filing for workers’ compensation altogether. While OWCP officials say there are no case backlogs, the agency admits that consistent staffing remains an issue.” In response to the agency’s staffing woes, the Biden administration added 281 new claims examiners and 55 medical treatment adjudicators in the last few years. In 2022 Federal Employees’ Compensation Act (FECA) claims numbered 182,303, a 62 percent increase compared to claims nearly ten years ago in 2013 when the agency reported just 112,807. 


The Division of Workers’ Compensation (DWC) will host its annual fee schedule meeting on August 15

injured-workers-pharmacy-blog-coloradoOn August 15th, the Division of Workers’ Compensation (DWC) will host its annual Rule 18 meeting concerning the state’s medical fee schedule commencing at 10 AM MST. Of the changes put forth, no reimbursement changes were observed for prescription care. However, the agency will add a requirement to Rule 18 that all opioids and certain scheduled controlled substances, including benzodiazepines, must be provided through a pharmacy. Other alterations to the rule include updated billing codes, professional reference standards, hospital fees, and ambulatory charges. 


A statewide audit of the state Workers’ Compensation Commission (WCC) found that regulators failed to adequately track employers who did not carry workers’ compensation.

injured-workers-pharmacy-blog-marylandA recent audit of the state’s Workers’ Compensation Commission (WCC) found that regulators failed to properly track employers who do not carry workers’ compensation insurance. Following an audit from the MD General Assembly’s Office of Legislative Audits determined that the WCC “did not use available information to proactively identify employers that did not have the required workers’ compensation insurance.” The Legislative Audit Sector also reported that the WCC failed to utilize records from the state’s Department of Labor to appropriately identify employers that may not hold active workers’ compensation coverage. The audit that observed coverage from August 2018 through September 2022 identified 1,650 potential employers that “appeared” to lack insurance coverage. When examining case docket records, the audit shows that 21 percent of employers scheduled for hearings were not listed in tacking records and that 76 percent of records did not display the outcome of the cases. 


New findings from NIOSH and the Ohio Bureau of Workers’ Compensation (BWC) highlight injury risks for firefighters.

OHA new study from the National Institute for Occupational Safety and Health (NIOSH), in partnership with the Ohio Bureau of Workers’ Compensation (BWC), concluded that workers’ compensation claims among firefighters in the state declined over a period of nearly two decades carrying objects) and being struck by equipment. Sprains of the back and those of the lower and upper extremities were the most common injuries reported from the occupational group. Findings also confirmed what similar studies already show in that firefighting tasks are “associated with exposures to harmful substances or environments.” West Virginia University assisted with the study’s research. 


Agency personnel from the Division of Workers’ Compensation (DWC) formally adopted amendments to its Medical Quality Review Panel.

TXThe Division of Workers’ Compensation officially adopted amendments to its Medical Quality Review Panel protocols. Rules affected include 180.64, 180.66, 180.68, 180.72 & 180.76. Changes from the Division were necessary to conform with “related rules and practices.” Newly amended language will clarify the amount of notice to which a respondent is entitled prior to an informal settlement conference and permit the Division to conduct informal conferences remotely or in person. Personnel from the DWC say they also made some editorial changes to ensure consistency with agency-style writing. Adopted amendments will be published in the Texas Register on August 18th. 


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